The Commons health committee has put part of the blame for recent accident and emergency performance on Andrew Lansley’s NHS reforms.
A report issued today on the problems in A&E since the start of the year said the abolition of primary care trusts and strategic health authorities in April had “removed” some of the “system management” that had been in place. The measures were put in place as a result of the former health secretary’s 2012 Health Act.
It said “local oversight appears necessary” to restore control.
The hospital sector in England missed the four-hour A&E target in the last quarter of 2012-13 and the committee said there appeared to be no single factor that explained it.
Their report also criticised the system NHS England put in place to deal with the problems in A&E departments at the start of the year.
Urgent care boards were set up by NHS England in May to bring together commissioners and providers in addressing the delays to treatment in A&E.
A report issued today by the Commons committee said: “[We are] not persuade[d] that urgent care boards will be able to implement reforms and influence commissioning.
“From the evidence presented by NHS England it was unclear whether urgent care boards are voluntary or compulsory, temporary or permanent, established structures or informal meeting groups.”
It added: “We believe [they] have potential to provide local system management but they have no executive power and no clear direction.”
Further evidence emerged of the provider sector’s scepticism about urgent care boards in the results of a survey released by the Foundation Trust Network.
A quarter of respondent said local plans were still not agreed or did not exist, while more than half described the plans as “underfunded”.
FTN chief executive Chris Hopson said: “Eighty one per cent of our members told us in May that they expected next winter to be worse or the same. The NHS response was to create a new urgent care board local planning process. But this survey shows that process is already failing.”
The MPs also made special criticism of the Department of Health’s statistics on delayed transfers of care.
The committee said it had received evidence of delays to the discharge of patients who were medically fit but were awaiting a social care place.
The report said clinicians and hospital managers had identified this as a “fundamental problem which inhibits patient flow” but “official data says fewer bed days are being lost to lack of social care rather than more.
“The discrepancy between the evidence of people working with patients and the formal data is striking and we find the data incredible.”
The DH had not commented on the report as HSJ went to press.
The committee, chaired by former health secretary Stephen Dorrell, said the staffing levels in emergency departments were a “considerable concern” and “not sufficient to meet demand”.
The report said only 17 per cent of departments provided 16-hour consultant cover during the working week and the situation was worse at the weekend.